14 March 2013

New attempt at assisted suicide

Euthanasia is once again back on the parliamentary agenda.

Lord Falconer has announced that he will seek to introduce another assisted suicide bill in the House of Lords in May backed by Dignity in Dying (the former Voluntary Euthanasia Society). Lord Falconer recently charied a sham Commission on Assisted Dying which was boycotted by most campaign groups due to its obvious bias. Following a report, a draft bill was published by Falconer in 2012 and formed the basis of a private consultation run by Dignity in Dying. Many individuals and organisations, however, chose to ignore the consultation, again due to its perceived bias, and although it closed last autumn, no 'report' has ever been published.

The new Bill based on the Falconer Commission is likely to press for doctors to be empowered to help mentally competent adults considered to have less than one year to live to kill themselves. As with the Abortion Act, just two doctors' signatures would be required. Falconer is modelling his proposals on the U.S. state of Oregon model which involves assisted suicide for mentally competent adults who have less than six months to live. In Oregon, such citizens regarded as terminally-ill are permitted 'to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose'. Their Lordships should note that Falconer's Bill, however, only requires a twelve month life expectancy and so is even more liberal than Oregon's. Falconer's so-called proposed 'safeguards' look very similar to those in the Joffe Bill which the Lords rejected in 2006.

An opinion poll in September 2012 suggested that more than seven out of ten MPs would not support a change in the law which probably explains why Lord Falconer has decided to commence the Bill in the Lords, despite significant previous defeats there in recent years. There have been three failed attempts to legalise assisted suicide in Britain in the last six years, in 2006, 2009 and 2010, all of which failed due to concerns about public safety.

Simultaneously, the Member of the Scottish Parliament Margo MacDonald is also planning to present a Bill based on the Oregon model to the Scottish Parliament. Margo MacDonald's previous Scottish bill was defeated by an overwhelming majority of 85-16 in 2010.

There are many agendas associated with the pro-euthanasia movement and a critical danger is that once the principle of assisted suicide is established incremental extension will almost certainly be encouraged. Care Not Killing reports alarming news of incremental extension in jurisdictions which have legalised assisted suicide or euthanasia, like Belgium,the Netherlands,Switzerlandand also Oregon, wherestatistics released last month show that the number of assisted suicide prescriptions and deaths increased again in 2012 and has now reached an all-time high.

Care Not Killing identifies a major factor regarded as fuelling this increase as suicide contagion - the so-called Werther effect. This is particularly dangerous when assisted suicides are backed by celebrities and afforded high media profile as they are frequently by the BBC. There are also major worries about the effect the recession is having on vulnerable people and healthcare provision. Concerns have grown that any change in the law would increase pressure on elderly, sick and disabled people to end their lives.

In Belgium, euthanasia is now considered by many to be seriously out of control. Doctors in Belgium recently featured in world headlines when they announced just before Christmas that they euthanised 45-year-old, deaf, identical twins who were going blind and thought that they had nothing to live for. Under Belgian law euthanasia is allowed if 'the patient is in a medically futile condition of constant and unbearable physical or mental suffering that cannot be alleviated, resulting from a serious and incurable disorder caused by illness or accident'.

Critics highlight that the twin brothers were not terminally ill nor suffering physical pain. However, Professor Wim Distelmans, a right-to-die activist and one of the doctors involved in the decision to euthanise the twins, based his approach on his own assessment of their supposed psychological suffering. This case demonstrates in graphic terms the liberal extent to which Belgian euthanasia law is now being interpreted.

According to Care Not Killing, euthanasia also appears to be getting out of control in the Netherlands. Dutch statistics indicate that euthanasia deaths in 2011 increased by 18% to 3,695. This follows increases of 13% in 2009 and 19% in 2010. In fact from 2006 to 2011 there has been a steady increase in numbers each year. Euthanasia now accounts for 2.8% of all Dutch deaths.

In addition, euthanasia for people with early dementia doubled to 49 last year and 13 psychiatric patients were euthanized compared with only two reported in 2010. Even so, such alarming statistics tell only part of the full story. A 2012 study in The Lancet indicated that in 2010, 23% of all euthanasia deaths in the Netherlands were not reported at all meaning that the total number of deaths that year was in fact significantly understated. At the same time there has also been a significant rise in deep-continuous sedation. This involves doctors deeply sedating patients and then withholding fluids with the explicit intention that they will die. Whilst official euthanasia deaths are rising year by year in the Netherlands, these deaths represent only a fraction of the total number of deaths resulting from Dutch doctors intentionally ending their patients' lives through deliberate morphine overdose, withdrawal of hydration and sedation.

Such major increases in assisted suicide cases in countries like Belgium, the Netherlands and Switzerland, and U.S. states like Oregon ring out clear warnings to the U.K. At the present time key official medical bodies like the Royal College of Physicians, the British Medical Association and the Royal College of General Practitioners, along with disability groups like SCOPE and RADAR, remain firmly opposed to a change in the law. Against such a background it seems unlikely that Lord Falconer's latest Bill will make much progress in the House of Lords. However, peers will need to be reminded about the continuing strong arguments against legalisation of assisted suicide, not least in view of the constant pressure from right to die groups that exert major influence on public opinion through hard cases featured by the media, and through continuing evidence of worrying developments in Europe and elsewhere.